We spoke with US-based neurologist Ethan Russo MD, Director of Research and Development at the International Cannabis and Cannabinoids Institute, at the 2019 IACM Cannabinoids in Medicine conference in Berlin, Germany. Dr. Russo outlined challenges for conducting clinical trials of cannabis for the various medical conditions that are already supported by subtantial evidence warranting further studies. He explained the problem of getting funding and approvals for clinical trials. Dr Russo described the impact of increased placebo-responses over the past decades, and that subjects may see through blinding if they feel intoxicated, but notes the existence of a sweet-spot where symptoms can be treated without intoxication. The argument that cannabis use may increase the likelihood of triggering psychosis or schizophrenia in patients is also addressed. Dr Russo said the incidence of schizophrenia in society had dropped despite a significant increase in recreational cannabis use. He also notes that there is no impairment in patients using normal doses and that cannabinoid medicines can be prepared that do not intoxicate, but that precautions should be taken. Dr Russo points out that in two recent Phase II clinical trials CBD has been shown to treat schizophrenia with far fewer side effects than traditional antipsychotic medicines.

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